Text to prevent repeat heart attacks

Written by Kate McDonald on 23 September 2015.

Sydney researchers are calling for the implementation of a simple text message system to improve the health of heart attack survivors after it was shown to help reduce weight, blood pressure and cholesterol and was well received by patients.

Westmead Hospital cardiologist Clara Chow said the Tobacco, Exercise and Diet Messages (TEXT ME) trial used a very simple mobile health strategy that could be provided routinely by hospitals as part of a discharge program for heart attack survivors as well as other conditions like stroke.

The TEXT ME trial used an automated, computerised message management system to send texts selected from a bank of messages to trial participants. The messages gave advice and motivational reminders about diet and nutrition, exercise and smoking, based on freely available resources such as those provided by the Heart Foundation.

The trial involved 710 people attending Westmead Hospital with proven coronary heart disease. Half received four text messages a week for six months in addition to standard care, while the remainder received their standard care.

At six months, levels of LDL-C were significantly lower in the intervention group, with concurrent reductions in systolic blood pressure and body mass index. It also saw significant increases in physical activity and a significant reduction in smoking.

Patients also received the intervention well, with 91 per cent reporting that the program was useful, easy to understand (97 per cent), and appropriate in frequency (86 per cent).

Associate Professor Chow, also the director of the cardiovascular division at the George Institute for Global Health, said people often just needed ongoing encouragement to change their lifestyles, especially when they are confronted with the daily challenges outside of hospital, and this program addressed that problem.”

“It’s also cheap, with the text messages costing just $14 per patient for a six-month period,” she said.

This is in comparison to the $281,000 that each heart attack costs the community, a figure that includes direct healthcare costs as well as lost productivity.

“Ultimately we’re trying to save lives,” Dr Chow said. “We know that more than 4000 incidents and 1880 deaths could be stopped every year if we reduced repeat heart attacks by 25 per cent. It would be great if we could achieve this.”

She said mHealth strategies such as this could be introduced by governments with immediate results.

“We are committed to rolling this program out to hospitals around the country, and continuing to test the benefits.

“It is something that hospitals could routinely provide as part of the discharge program for patients with heart attacks or even other conditions such as stroke.

“This is one of those relatively rare things in medicine that saves money and could save lives also, so given its simplicity and the results of this research, it really is a no brainer.”